Trumps Health Plan Would Convert Medicaid to Block Grants, Aide Says

[geek tragedy]

Source: NY Times

WASHINGTON — President Trump’s plan to replace the Affordable Care Act will propose giving each state a fixed amount of federal money in the form of a block grant to provide health care to low-income people on Medicaid, a top adviser to Mr. Trump said in an interview broadcast on Sunday.

The adviser, Kellyanne Conway, who is Mr. Trump’s White House counselor, said that converting Medicaid to a block grant would ensure that “those who are closest to the people in need will be administering” the program.

A block grant would be a radical change. Since its creation in 1965, Medicaid has been an open-ended entitlement. If more people become eligible because of a recession, or if costs go up because of the use of expensive new medicines, states receive more federal money.

If Congress decides to create block grants for Medicaid, lawmakers will face thorny questions with huge political and financial implications: How much money will each state receive? How will the initial allotments be adjusted — for population changes, for general inflation, for increases in medical prices, for the discovery of new drugs and treatments? Will the federal government require states to cover certain populations and services? Will states receive extra money if they have not expanded Medicaid eligibility under the Affordable Care Act, but decide to do so in the future?

Read more: https://mobile.nytimes.com/2017/01/22/us/politics/donald-trump-health-plan-medicaid.html

---

He is a typical Republican who wants poor people to die of preventable causes.

[roamer65]

1. It equals rationed healthcare...basically a death sentence.

It will be the hallmark of the new DPP. The Death Penalty Plan.

There will either be a dollar limit or certain procedures/treatments will be off limits.

[cstanleytech]

9. Correction, it would actually be the RDPP after all

its only right to include the R there since its the Republican plan.

[Fast Walker 52]

22. yes, we need to rebrand these people as GOP psychokillers

[TheMastersNemesis]

2. BOCK GRANTING MEDAID WILL ENABLE STATES TO BILL CHILDREN OF PARENTS FOR LONG TERM CARE.

Children get ready to pay for you mother or father's long term care. Under present federal law the states CANNOT GO AFTER THE ASSETS OF THE CHILDREN when a parent goes into a nursing home under Medicaid. Right now once a parent exhausts all their assets and goes on Medicaid THE CHILDREN'S ASSETS ARE PROTECTED UNDER FEDERAL LAW.

Under a block grant system THAT FEDERAL PROTECTION DISAPPEARS. So the states could FILE LIENS AND GARNISHMENTS ON THE INCOME OF THE CHILDREN to FORCE THEM TO PAY FOR THE LONG TERM CARE.

Before the Medicaid law the children were LIABLE and had to pay toward long term care. IT WAS A LEGAL DEBT ASSESSED BY STATE SOCIAL SERVICES.

I KNOW THIS WAS TRUE BECAUSE MY MOTHER'S SISTERS HAD TO PAY SO MUCH PER MONTH FOR MY GRANDMOTHERS CARE IN THE STATE OF ILLINOIS. My mom did not have to pay because she lived out of state.

[Phoenix61]

12. The Deficit Reduction Act of 2005

The adult children of elderly parents in many states could be held liable for their parents' nursing home bills as a result of the new Medicaid long-term care provisions contained in a law enacted in February 2006. The children could even be subject to criminal penalties.


http://www.elderlawanswers.com/adult-children-could-be-on-hook-for-parents-nursing-home-bills-5181


http://www.elderlawanswers.com/medicaids-asset-transfer-rules-12015

[TheMastersNemesis]

13. Interesting - It Was A Republican Initiative.

[DallasNE]

35. The Reverse Of That Is Also True

If you are a parent and have an adult child that is disabled they cannot draw benefits until your lifetime savings have been depleted. At least that is the case where it is a mental health disability because for the purpose of benefits that disability does not meet the definition of disability. The only insurance on the market now is high premium, high deductible and so subsidies are available. And that was before Donald Trump. Can't pull your weight, die. That is how mean the streets have become.

[Granny M]

24. Our family's worst nightmare.

My mother-in-law needs full time nursing care. Medicare will stop paying shortly. as she has reached a plateau in her rehab. They have applied for Medicaid, and we are all holding our collective breath, hoping that it will come through before Medicare cuts her off, and before trump destroys it. None of us have a lot of money.

It's so sad - she keeps saying, "Just shoot me," not because she's suffering badly, but because she doesn't want to be a burden.

[exboyfil]

33. Since my mom moved my grandma to my state (Iowa)

and dumped responsibility for getting her into LTC in my lap, I have been concerned about this eventual development. She spent nine years in a wonderful nursing home at a Medicaid cost of nearly $1/2 million dollars before passing away last year. My mom, who also voted for Trump, just muttered something about paying taxes for it when I mentioned it.

I now have my mom and her eventual LTC to also consider. I will make absolutely sure she stays in Florida which does not have a filial support law. I will not sign any paperwork for her regarding her eventual LTC location. I will make sure she uses up her assets, and I have never taken a dime from her, and I never will.

When this crap comes up, why don't any "REPORTERS" ask about this issue? It is an important national discussion.

[TeamPooka]

3. Congrats America, you get a coupon. Good luck!

[DallasNE]

4. Block Grants Become Piggy Banks For Governors

To bankroll their pet projects so much of the money never makes it to the intended group of people. Some would probably even be use it to pay for tax cuts for the very wealthy.

[Cracklin Charlie]

7. My first thought.

Plus, there's the added bonus of adding another level of bureaucracy; allowing a second golden opportunity to siphon off the taxpayer's money, for really, whatever they want.

Please stop robbing us.

[maxrandb]

30. Or, just make sure the money only goes to white people

Think I'm joking? Ever been to Alabama to Mississippi?

[stuffmatters]

18. That's the Repub plan...plug their trickle down holes with medicaid money

Hasn't Brownback already diverted funds meant for his constituents' healthcare into the bottomless deficit his Kochonomics has created?

[kimbutgar]

5. And don't forget the rethug governors can divert the funds to fix their budget holes

I see the GOP compliant congress changing those rules. No healthcare if we can't afford those tax cuts to find basic services and pay high salaries to the governor and elected officials..

[geomon666]

6. Oh my god, this is a fucking death sentence

Especially if you live in a red state.

[tanyev]

23. I bet the blue states would have more trouble receiving their funds.

Unexplained bureaucratic glitches, specifically targeted strings attached--there's many ways it could happen.

[Cryptoad]

8. WTF.....

Medicaid is already administered by the States,,,,,,,,Thats teh problem now, Many of the Red moocher states skim this money and the poor will not receive adequate health care.....

[cstanleytech]

16. The problem is right now the feds have alot of rules about how the states can manage it but if the

federal rules go out the window and its entirely up to the states you will see alot of people suffering needlessly as the states trim the service to be pretty much worthless.

[murielm99]

10. Illinois still cannot get a budget

bill passed because of the stupid repubbie governor, Bruce Rauner, aka the ruiner.

How are they going to delegate this money when they are already in such disarray?

[jmowreader]

17. Easy! All to tax cuts, none to Medicaid.

[frazzled]

11. This is insupportable

There are lots of things I care about that are at risk with this administration--everything from women's rights and civil rights, immigration, the environment, criminal justice, and foreign policy (this last one a biggie).

But I am making this my main focus in the next weeks and months. We must not allow this to happen.

[TalenaGor]

14. my mother just moved into a nursing home 2 days ago on medicaid....

she'd been in the hospital for 6 months - they saved her life and because of the annual max shes only had a few thousand in bills....
we struggled to get her approved for a place (should be temporary I hope)

I cannot afford to pay her nursing home bills OMG - its over 3k per month

[Cha]

15. Good Luck with everything

[stuffmatters]

19. This is obscene...the majority of Americans will someday need medicaid for nursing homes

As far as I know, medicaid has always been the main provider of nursing home funds for the elderly. Very, very few people in their last years can pay many thousands per month.
I've always been mystified that all Americans do not know this that Medicaid pays for nursing homes.. Medicaid is framed by the Repubs as for "poor people," but it's really for almost everybody, because few people have a million dollars in their last years or could ever afford "long term care" policies.
This block granting medicaid has already been aptly called the Repub "let grandma die on the street" plan. Dems gotta start yelling this loud and relentlessly.

[greymattermom]

29. Better yet

Let grandma move in with you. And let you do all of her care. Bill.

[stuffmatters]

38. Yes, that's been mentioned as Repub Plan B:" Let Grandma die on your couch"

[DeminPennswoods]

39. 60% of Medicaid goes to nursing home care

I just read that the other day. Around here, private pay for nursing home care is around 10k/mo or about $300/day.

[wishstar]

20. Nixon federalized SSI (Assistance to disabled and elderly) - Reagan suggested federalizing Medicaid

Reagan and Repub Sen. Lamar Alexander both proposed Feds taking over Medicaid funding entirely, while turning over education funding to states, but now Repubs are so anti-Federal, they won't consider anything giving Federal govt more authority.

Many states were so bad at administering their low income assistance programs for disabled and elderly, that even Nixon's Administration federalized SSI under jurisdiction of Social Security Administration to put all local/state welfare programs under one eligibility standard. (while allowing more generous states to have additional supplements)

[Tanuki]

21. Seema Verma, Trump's nominee to head the Center for Medicare and Medicaid Services,

has an appalling record:
http://www.prwatch.org/news/2017/01/13198/seema-verma-trump-pick-medicaid-and-medicare

"Verma is founder and CEO of the Indiana health consulting business, SVC Inc. She worked as a consultant for several states but forged her reputation as a reformer with former Indiana Governor Mitch Daniels and current Governor and VP-elect Mike Pence, both conservative Republicans with ties to the American Legislative Exchange Council. ALEC has long opposed any expansion of Medicaid and has sponsored model bills to privatize and chip away at the program.

In Indiana, Verma helped design the Healthy Indiana Plan (HIP 2.0), which is described as a "consumer-driven insurance program for low-income Hoosiers." However, others such as the Kaiser Family Foundation have noted that it is one of the most complex and restrictive experimental programs ever given a waiver by the federal government which gives states some leeway to tinker with the program.

..........

Under Verma's program, Medicaid recipients can't get complete benefits unless they pay new monthly premiums. People that are poor enough to qualify for Medicaid in Indiana can actually be locked out of their coverage for six months if they fail to make a payment. The overly strict rules of the state also impose charges on patients that make what are deemed to be too many emergency room visits.

A July report from the Lewin Group, a health consultancy firm, found that 21,500 beneficiaries below the poverty level were dropped from Indiana's HIP Plus to HIP Basic because they didn't pay their contributions on time. One woman reported losing health care coverage after the state lost track of her $1 payment.

..............

In addition to Indiana, Verma has contracted with other Republican-led states, including Iowa, Ohio and Kentucky. She consulted with them on submitting Medicaid expansion proposals to the federal government. Her proposal for these states also layered on the punitive provisions such as requiring recipients to pay for more of their care, and making their coverage contingent on them actively working or looking for work, ideological aspects that might appeal to conservative Republicans have nothing to do with health care delivery and results.

According to a 2014 report by the Indianapolis Star Tribune, Verma and her firm have received at least $3.5 million from state contracts in Indiana alone.

.........

[bucolic_frolic]

25. So so Wall Street

the guys who serve turkey in a homeless shelter on Thanksgiving
to classify as philanthropists

[dlk]

26. Block Grants Are a Money Grab

Republicans like block grants because it's easier for them to redirect taxpayer dollars into their own pockets.

[WhiteTara]

27. Also, block grants can shift from the original

intent to another area of state government.

[BlueCaliDem]

28. Yeah, but at least he didn't do Wall Street speeches or used a private server, right? No matter that

now Trumputin is rResident and we have a Republican controlled Congress, Medicare is being attacked and will most likely be killed as we know it. Or that people who now can afford health care insurance that's fairer to everyone will lose that security. Or that Social Security will be chipped away at until there's nothing left.

Voting for 'liberal' Putin-patriot, Jill Stein, over 'corrupt' Hillary Clinton with her private server and her Wall Street speeches (as a private citizen, btw) was worth it! It was worth losing Medicare, Social Security, and making health insurers more fair to working Americans. I wonder what Bernie is going to do about Trumputin's attacks on our social safety net? My guess? A whole lot of NOTHING.

[center][/center]

[greymattermom]

31. Red states should hire Cuban doctors

to come up with a health care plan that is affordable. I'm sure they have some good ideas.

[Grins]

32. The myth: States are best equipped to blah, blah, blah...

Heard this for years going back to Reagan. And believed a lot of it.

At the time I worked A LOT with federal gov't people and agencies, then had state and local added to the pile. What an eye-opener!! Graft, diversion of funds, multiple procurement and reporting policies, overhead and mismanagement. Only the threat of fed audit kept some of them back from really shitting the house.

[alarimer]

34. Because this worked so well for welfare..

Thanks to Bill Clinton and the Republicans in the 1990s. Now a lot of the money meant for welfare is used for other things, like marriage "education" for middle-class white people. Not that they shouldn't have that, it just shouldn't come from money that is supposed to help the poor. In a lot of cases, though, the money was simply used to fill gaps in state budgets where taxes have been cut to the bone. I expect turning Medicaid into block grants will be used the same way: not for health care.

Reveal had a good show on it.

https://www.revealnews.org/episodes/a-welfare-check/

[Sunny05]

36. K&R / nt

[herding cats]

37. A couple of informative links on what block grants mean for Medicaid.

I suggest we read up and educate ourselves on our fight ahead.

http://www.commonwealthfund.org/publications/issue-briefs/2016/nov/medicaid-block-grants


http://khn.org/news/block-grants-medicaid-faq/

The latter one is a bit out of date under Trump. I'm sure they'll be putting out a newer one soon.